Ethical issues related to research
Mail: mantzorou@ for more related articles at health science ound: research ethics involve requirements on daily work, the protection of dignity of subjects and the publication of the information in the research. However, when nurses participate in research they have to cope with three value systems; society; nursing and science which may be in conflict with the values of subjects, communities, and societies and create tensions and dilemmas in nursing. Method and material: using the medline and the nursing cinahl data base, the most important ethical issues which appear in bibliography, will be addressed. After a short description of the nature of nursing, and the advocacy role of nurses, the writer will attempt to highlight the possible conflicts that nurses have to deal with, when undertaking or participating in research. Results: the major ethical issues in conducting research are: a) informed consent, b) beneficence- do not harm c) respect for anonymity and confidentiality d) respect for privacy. However, both the nature of nursing which focuses on caring, preventing harm and protecting dignity and the advocates role of nurses which calls for defending the rights of subjects, are sometimes incongruent with the ethics in research. Conclusions: ethical issues, conflicting values, and ambiguity in decision making, are recurrently emerging from literature review on nursing research. Because of lack of clarity in ethical standards, nurses must develop an awareness of these issues and an effective framework to deal with problems involving human ch ethics, moral dilemmas in research, nature of nursing, nursing research, nursing is rooted in the ancient greek philosophical inquiry of moral life. Scientific research work, as all human activities, is governed by individual, community and social values. Research ethics involve requirements on daily work, the protection of dignity of subjects and the publication of the information in the r, when nurses participate in research they have to cope with three value systems; society; nursing and science. The societal values about human rights, the nursing culture based on the ethic of caring and the researcher's values about scientific inquiry. After a short description of the nature of nursing, and the advocacy role of nurses, the writer will attempt to highlight the possible conflicts that nurses have to deal with, when undertaking or participating in ical overview- ethical experimentation has been conducted even before 18th century. However, the ethical attitudes of researchers drawn the interest of society only after 1940's because of human exploitation in several cases. 4] the nazi experiments led to the nuremberg code (1947) which was the leading code for all subsequent codes made to protect human rights in research. This code focuses on voluntary informed consent, liberty of withdrawal from research, protection from physical and mental harm, or suffering and death. 5] the only weak point of this code was the self regulation of researchers which can be abused in some research studies. It was only in 1964 with the declaration of helsinki that the need for non therapeutic research was initiated. 6] the declaration emphasised the protection of subjects in this kind of research and strongly proclaimed that the well being of individuals is more important than scientific and social interests. Since then there has been a significant development of professional codes in conduct and research. The american nurses' association (ana) guidelines for research, the human rights guidelines for nurses in clinical and other research (1985) and the royal college of nursing code for nurses in research (1977) provide a strong assistance to professional nurses as well as reassurance to patients, the public and society, of professionals’ intentions. 3] of course individuals can make informed decisions in order to participate in research voluntarily only if they have information on the possible risks and benefits of the research. 12] free and informed consent needs to incorporate an introduction to the study and its purpose as well as an explanation about the selection of the research subjects and the procedures that will be followed. 13] the researcher must inform the subjects about the methods which will be used to protect anonymity and confidentiality and indicate a person with whom they can discuss the study.
Describe one ethical issue related to research
The researcher must also take into account that persons with physical, cultural and emotional barriers may require a very simple language in order to understand him. 5] this is very important but raises the issue of how difficult the subjects can withdraw after developing a personal and sometimes friendly relationship with the researcher. 12] with regard to withdrawal a researcher may be in a dilemma in case many subjects choose to withdraw at an advanced stage of the study, because this can affect the validity of the results. 3] according to this, the will of the subject must be respected at any cost for the r major ethical issue is obtaining an informed consent from groups with diminished autonomy which will be further discussed later. Do not ethical principle of beneficence refers to the hippocratic "be of benefit, do not harm". The principle of beneficence includes the professional mandate to do effective and significant research so as to better serve and promote the welfare of our constituents". Carr says that if the research findings prove that it was not beneficial as it s expected, this can raise immense ethical considerations especially for nurses. 16] ford and reutter say that "beneficence relates to the benefits of the research, while non-malificence relates to the potential risks of participation". A researcher tries to learn intimate details of the participants lives he has to deal with opening old wounds. A researcher must consider all possible consequences of the research and balance the risks with proportionate benefit. If the researcher is not able to promise anonymity he has to address confidentiality, which is the management of private information by the researcher in order to protect the subject's identity. Clarke addresses the ethical dilemma of the researcher when confidentiality must be broken because of the moral duty to protect society. If a researcher, though, acts deontologically he may feel that he has not protected society. Another issue is that the researcher may have to report confidential information to courts which can also dilemmas. 3] even if there are no duty conflicts, the researcher faces several problems with respect to maintaining confidentiality especially in qualitative research where conduct is personal, the sample is smaller and the reports display quotations of interviews. Department of health and human services (dhhs) may be useful to help ensure the privacy of research participants especially in studies in which participants and researchers may be exposed to compelled legal disclosure of research researchers must always bear in mind all psychological and social implications that a breach of confidentiality may have on subjects. All aims, instruments and methodology must be discussed with the prospective subject and the research workers prior to the and treece suggest that whenever subjects refuse to report personal information as they regard it an invasion of privacy, the researcher ought to respect their views. They also imply that privacy can be invaded when researchers study certain groups without their knowledge and without identifying themselves. An example of such a study that the researcher hid his identity, was humphrie's study "impersonal sex in public places" in which, he observed homosexuals during sexual activities in public men's rooms. 5] in conclusion, all possible measures have to be taken in order to protect subjects from potential physical, psychological or social damage during the research or after circulation of the results. Groups of ys, there is an increased concern about vulnerable groups and whether it is ethical or not for them to be used as research subjects. 23] so, vulnerable groups include captive populations (prisoners, institutionalised, students etc), mentally ill persons, aged people, children, critically ill or dying, poor, with learning disabilities, sedated or different opinions about their participation in research can be attributed to their inability to give an informed consent and also to their need for further protection and sensitivity from the researcher as they are in a greater risk of being deceived, threatened or forced to participate. Many are in favour of the use of such subjects in research whilst others would argue strongly against it.
Most condition their responses according to the seriousness of the research, the level of potential risk and the availability of alternatives. An intense analysis of potential risks and benefits should be the first step of starting such a research and careful approach should exist both in acquiring consent and during the research procedure itself. In the case of mentally ill patients, it is important to measure comprehension and develop valid tools for it, before obtaining informed consent to participate in a research study. 25] however, the potential improvement of their nursing care raises the issue of careful consideration before rejecting or accepting this kind of of the n declares that in research the three more important elements are the competency of the researcher, the careful design, and worthwhile expected outcomes. 13] the royal college of nurses declares that nurse researchers should have the necessary skills and knowledge for the specific investigation to be carried out and be aware of the limits of personal competence in research. Inexperienced researchers should work under qualified supervision which has to be reviewed by an ethics committee. Is more, careful choice of method for data collection, to ensure validity and reliability, are two main requirements that must be met in all kinds of research. When human beings are involved, all the ethical issues, discussed above, must be taken into account. 17] the role of nurses as advocates is closely related to the purpose of nursing, the nurses views about humans and the needs of persons in health care. Common feature in professional conduct codes and those specific to research is the principle of non-malificence. The ana code of conduct declares that the nurse protects the clients and the public from unethical, incompetent or illegal practice of any person. 8] this statement raises the issue of advocacy when nurses have to protect patients from the researchers’ incompetence or unethical behaviour. 13] if the researcher does not inform or compensate patient then nurses have to decide between the duty to safeguard the well-being of patient and be loyal to them, and the loyalty to r, even if nurses decide that their duty of caring and being loyal to the patient is more important, they may have to deal with the hierarchical and bureaucratic systems of institutions which demand loyalty to subordinates to the institution. In case the incompetent researcher is a higher status professional, nurses may be obliged to show loyalty, but this can conflict with loyalty to patients. This is merely why many authors believe that it may not be possible for nurses to act as advocates of subjects in research. Possible issue of conflict is that the caring nature of nursing with regard to the right of patients to the best treatment/care is sometimes conflicting with the aim of research in non therapeutic studies. According to the belmond commission the general aim of practice is to enhance the well being of individuals while the purpose of research is to contribute to general knowledge. This distinction highlights the differences in the aims of a nurse practitioner and a researcher. 43] clark warns that there is a danger that the members may have vested interests in a research. If instead of the patient and his needs, the central aims of the committee are personal interests, profits and academic prestige, then nurses will have none to share their concerns with, and deal with their dilemmas in research. 26] moreover, the committees should be less strict so as not to prevent knowledge development in issue of confidentiality which is stated as very important in the hippocratic oath, is another possible issue of conflict for nurses either as practitioners or researchers. 9] on the other hand the icn code for nurses in research states that: "nurses acting as data collectors must recognise that they are now committed to two separate roles " . To the professional code they can not reveal confidential information not even to the members of the research team.
26] in addition, they have to deal with the issue of anonymity when some features of the research make the subjects easy to identify. Involved in research, have to consider many ethical problems relating to the issue of informed consent. The icn code for nurses in research, states that nurses as practitioners may be called upon to witness that informed and voluntary consent has been obtained from the subjects of research. Webb suggests that the informed consent is an obligation of the researcher and no nurse should obtain it on behalf of another professional, nor agree to give the explanation as a substitute. Conflicting issue is that giving information to patients is accepted as a major role of the nurse; but if for the sake of a research, nurses have to withhold information, this may create conflicts when they have to decide whether to participate or not. 40] hurst suggests that if nurses cannot tell patients about the true research objectives, they should provide a full explanation at the end of data collection. 45] provided, of course, that a supervisor body has decided that disclosure should not be full in order not to invalidate the research t, can however, be a major ethical issue for nurses when it involves persons with diminished autonomy, such as children, aged, mentally ill etc. Nurses taking part in research on children should be alert, in order to notice any verbal or non verbal dissent which warrants exclusion of the child from the study (even if this creates conflicts with the researcher. 46] in the same prospect, nurses must act as advocates when vulnerable groups are used in research, and not prevent it. According to levine, restricting these groups from research could end in disadvantaging those populations, even further, especially when research involves no risk and a high potential for benefit. Role regard to nurse researchers, the international council of nurses declares that they are not responsible for the care of patients. 3] the commitment of nurses to caring, may create dilemmas according to the conflict between the researcher's and clinician's a researcher nurse provides physical or psychological care during an interview, the results will be biased and generalisation will be difficult. 5] another issue raised from the icn statement, is to determine when a "harmful situation appears imminent" and the intervention of the researcher is required. 3] this can solve some of the ethical dilemmas of the nurse, but in case the situation is not lifethreatening, the conflict remains. Burns and grove suggest that in case that support from the researcher is required, then, it should be given, but the subjects should be excluded from the research. Nevertheless, most health professionals, no matter how skilled they are in supportive techniques will provide some care if they feel that it is needed in a certain l issues, conflicting values, and ambiguity in decision making, are recurrently emerging from literature review on nursing research. Because of lack of clarity in ethical standards, nurses must develop an awareness of these issues and an effective framework to deal with problems involving human rights. This is necessary in order to come into terms with the issue of the researcher's values relative to the individual's rights versus the interests of society. Professional codes, laws, regulations, and ethics committees can provide some guidance but the final determinant of how research is performed, rests with the researcher's value system and moral code. He also declares that nursing, not as a biomedical branch, but as a science and art of caring, is able to start the redefinition of research in health care which was in the recent history dominated by the biomedical "paradigm". Nursing research,1982;(1): 43- college of nursing, ethics related to research in nursing, london,d p. Imedpub last revised : november 21, are going through a time of profound change in our understanding of the ethics d social research. There was a gradually developing consensus about the key ethical principles underlie the research endeavor.
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Cancer patients and persons fought publicly with the medical research establishment about the long time needed approval for and complete research into potential cures for fatal diseases. But now, those who were threatened illness were saying to the research establishment that they wanted to be ts, even under experimental conditions of considerable risk. You had several and articulate patient groups who wanted to be experimented on coming up against l review system that was designed to protect them from being experimented gh the last few years in the ethics of research have been tumultuous ones, it ing to appear that a new consensus is evolving that involves the stakeholder affected by a problem participating more actively in the formulation of research. Allowing anyone who is willing to be are a number of key phrases that describe the system of ethical protections contemporary social and medical research establishment have created to try to the rights of their research participants. The principle of ipation requires that people not be coerced into participating in is especially relevant where researchers had previously relied on 'captive audiences'. Closely related to of voluntary participation is the requirement of informed ially, this means that prospective research participants must be fully the procedures and risks involved in research and must give their consent ipate. Ethical standards also require that researchers not put participants in ion where they might be at risk of harm as a result of ipation. There are rds that are applied in order to help protect the privacy of research all research guarantees the participants confidentiality -- they d that identifying information will not be made available to anyone who is ly involved in the study. Increasingly, researchers have had to deal with the ethical issue of 's right to service. But when that treatment or program may cial effects, persons assigned to the no-treatment control may feel their rights access to services are being when clear ethical standards and principles exist, there will be times when to do accurate research runs up against the rights of potential participants. Furthermore, there be a procedure that assures that researchers will consider all relevant ethical formulating research plans. To address such needs most institutions and formulated an institutional review board (irb), a panel of persons s grant proposals with respect to ethical implications and decides onal actions need to be taken to assure the safety and rights of participants. Ing proposals for research, irbs also help to protect both the organization and cher against potential legal implications of neglecting to address important of ght 2006, william m. Trochim, all rights se a printed copy of the research methods revised: 10/20/ble of contentsnavigatingfoundationslanguage of researchphilosophy of researchethics in researchconceptualizingevaluation re might be the ethical issues and risks that arise in my research? University of are some examples of what might be an ethical issue or risk in research. This is not an exhaustive list – you may identify other issues in your own research project. You need to explain how you will deal with each of the issues or risks you s around versial / contentious / sensitive / embarrassing / upsetting s around en or young people are involved (under 18). Are my own students or ipants are an over-researched ipants do not understand english / might not adequately understand verbal explanations or written information / have low functional s around is a conflict of interest for the s around recruitment of ipants may be approached in a public ipation is not voluntary, or there is coercion or incentive to cher or faculty / department / university has a financial interest in the participant may not be able to withdraw from the ion is nature of the ipants may disclose that they have broken the or hazards to participants or al or mental risk or or pain / distress / discomfort to the participant or of samples e. Back to guidance on ethical approval for research main might be the ethical issues and risks that arise in my research? Back to guidance on ethical approval for research main ncbi web site requires javascript to tionresourcesall resourceschemicals & bioassaysbiosystemspubchem bioassaypubchem compoundpubchem structure searchpubchem substanceall chemicals & bioassays resources... Ping a research agenda on ethical issues related to using social media in sa, van veghel d, dekker ctthe consequences of using publicly available social media applications specifically for healthcare purposes are largely unaddressed in current research. Where they are addressed, the focus is primarily on issues of privacy and data protection. We therefore use a case study of the first live twitter heart operation in the netherlands, in combination with recent literature on social media from other academic fields, to identify a wide range of ethical issues related to using social media for health-related purposes.
Given the continual development of technologies, researchers may not yet be able to oversee and anticipate all of the potential implications. Further development of a research agenda on this topic, the promotion of guidelines and policies, and the publication of case studies that reveal the granularity of individual situations will therefore help raise awareness and assist physicians and institutions in using social media to support existing care ds: dutch heart operation; twitter heart operation; health-related; innovation in healthcare; public education; social mediapmid: 26059955 doi: 10. S0963180114000619 [indexed for medline] sharemesh termsmesh termsbiomedical research/ethics*cardiac surgical procedures/ethics*delivery of health care/ethics*humansnetherlandssocial media/ethics*social media/utilizationlinkout - more resourcesfull text sourcescambridge university press - pdfmedicalheart surgery - medlineplus health informationchoosing a doctor or health care service - medlineplus health informationpubmed commons home.